Reimbursement is key to the success of innovators who have products, therapies, and new modes of service for expectant and new mothers. Not only is it key to have the codes and contracts that are critical to billing, the payors themselves (both commercial and Medicaid) open the door to meeting the moms and babies for whom the products are intended.
Anna Zornosa (seated on the right), EIR with both BHI and the NIH, moderated a panel featuring three OB GYNS who represent key sectors of the reimbursement ecosystem: Dr. John Keats (first on the left), a maternal health expert with Cigna, represented the commercial insurer viewpoint; Dr. Barbara Levy, vice-chair of the AMA’s CPT panel, represented the view of how codes are established; and Dr. Miguel Fernandez (third from the left), spoke of his experience with Medicaid programs as Chief Medical Officer of Aetna Better Health of Florida. The three concurred that innovators need to lead with data showing the impact of their innovations on patients’ outcomes as the basis of initial conversations. The lively panel brought to life examples of successful innovator-reimbursement partnerships and responded to dozens of audience questions.